A comprehensive lipidomics study identified specific lipid profiles associated with cardiometabolic risk in children and adolescents with obesity. The research, conducted by Huang et al, also demonstrated these lipid signatures could be modified through personalized obesity management programs.

The cross-sectional study, published in Nature Medicine, analyzed plasma lipidomes of 958 children and adolescents with overweight or obesity and 373 with normal weight. Additionally, a longitudinal analysis examined 186 children and adolescents with overweight or obesity who underwent a family-based, personalized obesity management program for a median duration of 1.1 years.

The study found that children and adolescents with obesity exhibited elevated levels of ceramides and triglycerides, along with decreased levels of lysophospholipids and omega-3 fatty acids. Specific lipid profiles were associated with insulin resistance and cardiometabolic risk, with increased ceramides, phosphatidylethanolamines, and phosphatidylinositols correlated with higher risk, and increased sphingomyelins were associated with lower risk.

A panel of three lipids—PI(32:1), PE(36:1), and Cer(d42:0)—predicted hepatic steatosis with accuracy comparable to liver enzymes. The longitudinal cohort showed that nonpharmacological obesity management reduced levels of ceramides, phospholipids, and triglycerides, indicating partial restoration of a healthier lipid profile, and changes in lipid profiles mediated improvements in cardiometabolic traits.

Anthropometric and metabolic parameters revealed significant differences between the overweight/obesity subjects and the normal weight group. Liver fat, enzyme levels, and lipid profiles also differed between the groups. Glycemic parameters indicated increased insulin resistance in the overweight/obesity group, and inflammatory markers were elevated in the overweight/obesity group. The prevalence of cardiometabolic risk factors such as hepatic steatosis, hyperglycemia, insulin resistance, and hypertension was significantly higher in the overweight/obesity group.

The study utilized ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry for lipidomic analysis. A total of 227 lipid features from 16 different lipid classes were identified. 

Conflicts and ethics declarations are available within the original study.